脱冠状动脉旁路移植减少了动脉动动脉患者的死亡率和中风:一项病例对照研究
Ram Sharony1, Costas S Bizekis, Marc Kanchuger
1Division of Cardiothoracic Surgery, Department of Anesthesiology, New York University School of Medicine, New York, NY, USA.
Circulation
|September 13, 2003
概括
无冠状动脉绕道 (OPCAB) 手术显著降低了严重动脉瘤性大动脉疾病 (AAD) 患者的死亡率和中风. 与式手术相比,这种技术可以改善中期存活率和减少并发症.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 血管外科 血管外科
背景情况:
- 患有严重动脉瘤性大动脉疾病 (AAD) 的患者接受冠状动脉旁路移植 (CABG) 面临死亡和中风的风险增加.
- 假设脱冠状动脉绕道 (OPCAB) 可以减轻高风险人群中的这些风险.
研究的目的:
- 评估OPCAB与内CABG在重度AAD患者中的疗效.
- 评估手术技术对发病率,死亡率和长期存活率的影响.
主要方法:
- 对5737名CABG患者的回顾性分析,确定913人患有严重的AAD.
- 211名OPCAB患者与211名内CABG患者根据关键临床因素进行了匹配.
- 经食道心声扫描 (TEE) 用于例行手术内评估.
主要成果:
- 在OPCAB组 (3.8%) 的住院死亡率明显低于在组 (11.4%) (P=0.003) 的住院死亡率.
- OPCAB与中风发病率降低 (P=0.05) 和更高的无并发症 (91.9%与78.7%) 相关.
- 36个月的中期存活率得到了OPCAB的改善 (P=0.01).
结论:
- OPCAB手术与严重AAD患者的死亡,中风和并发症减少有关.
- 常规的手术内TEE有助于识别适合OPCAB的候选人.
- OPCAB为这种高风险患者队列提供了改善的中期生存率.
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